Active NPI
Meresiet Kidane, LCSW-C
- Clinical Social Worker
- Gaithersburg, MD
National Provider Identifier
1326775743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18925
- Practice address
- 9652 Kanfer CT
Gaithersburg, MD 20886-5065 - Phone
- (240) 350-4343
- NPI assigned
- Aug 5, 2022
- Last updated
- Aug 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC50082732 | DC | |
| Clinical Social Worker | 1041C0700X | 18925 | MD | Primary |
Addresses
Primary practice location
9652 Kanfer CT
Gaithersburg, MD 20886-5065
Mailing address
9652 Kanfer CT
Gaithersburg, MD 20886-5065
Phone (240) 350-4343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC50082732 | DC | MD | Clinical Social Worker |
| 18925 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1326775743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9652 KANFER CT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208865065",
"telephone_number": "240-350-4343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9652 KANFER CT",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208865065",
"telephone_number": "240-350-4343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDANE",
"first_name": "MERESIET",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-05",
"last_updated": "2022-08-05",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC50082732",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "18925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.